povidone-iodine and Cellulitis

The authors report a series of thirty-six perforating ulcers of the foot in diabetic patients, evaluated using M.R.I. M.R.I. showed osteomyelitis in 16 cases, cellulitis in 15 cases, osteoarthropathies in 21 cases, tenosynovitis of flexor tendons in 2 cases, oedema in 2 cases and abscess in one case. In 19 cases, M.R.I. was used to improve diagnostic accuracy. The medical treatment made use of thermo-moulded soles allowing for the recovery of walking, with a hole facing the perforating ulcer of the foot. The application of insulin-soaked sponges in the event of clean perforating ulcer of the foot and iodized solution in the event of infected perforating ulcer of the foot promoted healing. The treatment was only conservative, when the lesions were limited to the soft tissues. Surgical treatment was performed in 19 cases due to a global involvement of soft and osteoarticular tissues. In fourteen cases the surgical treatment was limited and was performed through the perforating ulcer. Resection of metatarsal heads or metatarso-phalangeal joints was performed in 10 cases, with resection of surrounding pathologic tissue. The surgical treatment was limited to the soft tissues in 6 cases. In 4 cases, M.R.I. findings resulted into a transmetatarsal amputation because the vascular plexus was of poor quality and infection spread from the perforating ulcer to the dorsal aspect of the foot. In our opinion, dorsal infectious involvement in a perforating ulcer of the foot, is a factor of poor prognosis. A below-knee amputation has been performed in one patient.

Topics: Abscess; Administration, Cutaneous; Adult; Aged; Amputation, Surgical; Anti-Infective Agents, Local; Bacterial Infections; Cellulitis; Diabetic Foot; Edema; Equipment Design; Follow-Up Studies; Foot Diseases; Humans; Hypoglycemic Agents; Insulin; Magnetic Resonance Imaging; Metatarsal Bones; Metatarsophalangeal Joint; Middle Aged; Osteoarthritis; Osteomyelitis; Povidone-Iodine; Prognosis; Shoes; Tenosynovitis; Walking; Wound Healing

Four cows and a calf with non-suppurative limb cellulitis were observed subsequently to suffer skin necrosis and sloughing in the affected limbs, either on or distal to the metacarpus or metatarsus. In comparison with six cows with suppurative Corynebacterium pyogenes limb cellulitis, topical therapy or the cases with skin necrosis and sloughing was adequate and the prognosis was good, when compared with the rigorous systemic therapy applied to the cows with suppurative cellulitis, some of which died. The skin necrosis and sloughing resulting from limb cellulitis seemed to be encouraged by the paucity of tissue between the skin and the bone, by the poor vascularity of the area, and by the causative bacteria.

Topics: Administration, Topical; Animals; Cattle; Cattle Diseases; Cellulitis; Debridement; Extremities; Female; Necrosis; Ointments; Povidone-Iodine; Prognosis; Skin; Tetracycline; Treatment Outcome

A five-year-old standardbred mare suffered a cervical oesophageal rupture subsequent to a kick. Marked cellulitis and extensive soft tissue damage resulted. Treatment consisted of creating an oesophageal fistula, local debridement and systemic antibiotics. The mare made a long but successful recovery. Treatment of oesophageal rupture in the horse is discussed.

Topics: Animals; Cellulitis; Combined Modality Therapy; Debridement; Drainage; Esophagus; Female; Gentamicins; Horse Diseases; Horses; Penicillin G Procaine; Povidone-Iodine; Rupture

Topics: Adult; Cellulitis; Facial Dermatoses; Humans; Male; Middle Aged; Povidone-Iodine; Suction; Therapeutic Irrigation